1. Commissioning for Autism - Making the strategy a reality Carol Povey Director of the Centre for Autism National Autistic Society

2. what's so different about autism the statutory framework and policies what about? - older people, women, people with high risk behaviours what about the money? ways forward

3. Provider commissioner relationship

4. What about the money? Wide ranging policy and structural changes Funding cuts Pressure in the system

5. What does that mean? Changing commissioning environment – less money to spend Resources targeted at those where needs can’t be ignored Funding decisions often delayed Could we find more creative ways of finding solutions?

6. What is Autism? DSM / ICD Recent changes to diagnostic criteria –Autism Spectrum Disorder  social communication and interaction.  restricted, repetitive patterns of behaviour, interests or activities. –Sensory differences are included in the 2 nd domain –Levels of severity

7. The National Autistic Society Service Delivery 7 independent schools NAS Academies trust 37 services Earlybird, Family Support Lorna Wing Centre (diagnostics and training) Autism accreditation Influencing Policy and campaigns Press and PR Informing National helpline – 80,000 calls Casework services Network Autism, training, conferences

8. Issues for commissioning Heterogeneity of the condition Spectrum Spiky profile Developmental condition Associated conditions

9. UK Policy and Practice Fulfilling and Rewarding Lives (2010) (England and Wales only) Implementing Rewarding and fulfilling lives (2010) NICE Guidelines Autism Strategy Review (England) – currently underway (2013)

10. Fulfilling and rewarding lives Improved training of all frontline professionals in autism. A recommendation to develop local autism teams Actions for better planning and commissioning of services, including involving people with autism and their parents/carers in this process Actions for improving access to diagnosis. Leadership structures at national, regional and local levels to support delivery Review 2013

11. Barriers to progress (your issues) Senior management buy in Lack of Guidance Difficulty in engaging health We are calling for the DoH to introduce an innovation fund for LAs, working in partnership with the voluntary sector, to assist the development, evaluation and dissemination of new service models.

12. What about Older people? Women People with high risk behaviours

13. Older people Most people on the spectrum are adults (1%) Most are supported by family Most have not had needs assessed

14. What do we know about the needs of older adults on the spectrum? Research on services for adults is sparse Mukeatova-Ladinska, Perry, Baron, Povey et al 2012

15. Women and Girls on the Spectrum What does autism look like in women? - Different Issues of vulnerability Self esteem Jennifer O’Toole http://asperkids.com/

16. People with high risk behaviours No reliable tools to assess risk in autistic people People get stuck in expensive secure environments Transition between health and social care funding as people move from secure environments to community setting puts barriers in the way of progress

17. transition Good transition plan after school prevents “heartache and expenditure down the line” Strategy CAMHS transitions protocols in place Data from school census should inform planning and commissioning Transition should be monitored to inform future planning

18. What about the money – Investing in “moderate” support Deloitte carried out some economic modelling on behalf of NAS, Scope, Mencap, Sense and Leonard Cheshire Disability Looked at 4 case studies of funding packages for individuals with moderate needs and modelled cost savings based on: –Costs of service –Attaching monetary values to the benefits of the service –Probabilities of reaching outcomes by accessing the service –Calculation of expected savings Overall findings: –For every £1 spent on support for adults with moderate care needs, an average of £1.30 will go back to local government, central government, the NHS and individuals

19. What about the money? (again) Getting the right support and services in place Kirklees Support for over 220 “Community Partnerships” Long term investment in those not eligible for FACS Using the Outcomes star to measure progress

20. Training STAGE 1 Staff should be able to identify autism Specialist training for key staff e.g CC assessors Autism awareness in equality and diversity training STAGE 2 LA should join with other orgs to share resources Autism lead, people on the spectrum and families should be involved STAGE 3 Training should meet skills for health / care framework All staff can refer to diagnostic pathway and support In depth training to those in decision making roles Surrey ; model of Autism Champions Each service supporting people with autism has autism champion Each champion has mentor Presently 74 champions across te County

21. Diagnosis and Care pathway STAGE 1 Clear pathway to diagnosis and assessment Diagnostician informs LA CC assessments carried out by trained assessor People given info on local support Access to PBs and DPs STAGE 2 NICE model pathways NICE recommendations implemented STAGE 3 Local service goes beyond diagnosis Staff training SEQOL in Swindon Social Enterprise providing range of health and Social Care services Multi Disc model of people who don’t “fit” existing services 2 post diagnostic meetings – opportunity to absorb news + needs assessment (psychologist and SaLT) Signposting service

23. England sign ups

24. What are good outcomes for adults on the spectrum? Quality of life – how do we define and measure this? How do we fully include people in defining what matters to them? What do we need to do to make the greatest difference for people?

25. 4073 members from 97 countries Mainly education, social care and healthcare professionals Most popular groups Autism and offenders (UK Forensic and Learning Disability Network) Sensory Ageing and Autism 39173 visits to date Ave 2500 monthly visits Network.autism.org.uk

27. Autism professionals awards Autism professional conference – March 4 th, 5 th 2014 Harrogate